To identify factors associated with loss to follow-up during treatment for multidrug-resistant (MDR) tuberculosis (TB) in the Philippines, we conducted a case-control study of adult patients who began receiving treatment for rifampin-resistant TB during July 1-December 31, 2012. Among 91 case-patients (those lost to follow-up) and 182 control-patients (those who adhered to treatment), independent factors associated with loss to follow-up included patients' higher self-rating of the severity of vomiting as an adverse drug reaction and alcohol abuse. Protective factors included receiving any type of assistance from the TB program, better TB knowledge, and higher levels of trust in and support from physicians and nurses. These results provide insights for designing interventions aimed at reducing patient loss to follow-up during treatment for MDR TB.

/pdf/factors-associated-with-loss-to-follow-up-during-treatment-17qsermt56.pdf

Factors Associated with Loss to Follow-up during Treatment for Multidrug-Resistant Tuberculosis, the Philippines, 2012-2014.

People across highly diverse cultural contexts use both natural and supernatural explanations to explain questions of fundamental concern such as death, illness, and human origins The present study examines the development of explanatory coexistence within and across domains of existential concern in individuals in Tanna, Vanuatu We examined three age groups: 7- to 12-year-old children, 13- to 18-year-old adolescents, and 19- to 70-year-old adults (N = 72) Within the domain of death, biological and spontaneous explanations were most common across all ages For illness, children showed the highest rates of explanatory coexistence, while adolescents and adults favoured biological explanations Within the human origins domain, theistic explanations were most common across the age groups Overall, these data show that coexistence reasoning in these domains is pervasive across cultures, yet at the same time it is deeply contextually specific, reflecting the nuanced differences in local ecologies and cultural beliefs


Statement of contribution
What is already known on this subject? 

Individuals across highly diverse cultural contexts use both natural and supernatural explanations to understand the events that occur in their lives
Context and cultural input play a large role in determining when and how individuals incorporate natural and supernatural explanations
The development of explanatory coexistence has primarily studied explanations for isolated domains


What does this study add? 

We examined explanatory coexistence in a culture with recent conversion to Christianity and formal education
The current research examines how individuals reason within and across the domains of human origins, illness, and death
Developmental differences associated with explanatory coexistence are examined

The coexistence of natural and supernatural explanations within and across domains and development.

This study documented ethnomedical knowledge of plants used for the treatment of tuberculosis (TB) and its related symptoms as practiced by the Jakun community of Kampung Peta, situated in Endau Rompin Johor National Park, Johor, Malaysia. Eight key informants were selected by snowball sampling technique and data about medicinal plants were collected by semistructured interviews, participatory observations, and focus group. Qualitative analysis was undertaken using thematic analysis. There were 23 species of plants (22 genera, 20 families) documented and herbarium specimens were deposited at the UTHM Herbarium. Dipterocarpus sublamellatus was recorded for the first time with ethnomedical uses while other species were previously reported. The qualitative approach employed in this study demonstrates the emic perspective in terms of perceptions on traditional herbal medicine, transfer of knowledge, significant taboos related with medicinal plants, and their conservation efforts. Local and biomedical terminology in treatment of TB showed substantial correspondence. The outcomes obtained in the study are worth being further investigated for conservation strategies and are worthy of verifying their ethnomedical claims scientifically.

/pdf/ethnomedical-knowledge-of-plants-used-for-the-treatment-of-4ka8z8zusr.pdf

Ethnomedical knowledge of plants used for the treatment of tuberculosis in Johor, Malaysia

Tuberculosis (TB) remains the prime killer disease among infectious diseases. TB control depends on early case detection and treatment in a directly observed treatment short course (DOTS) programme. The success of DOTS depends on the ability of the health care system to identify and properly manage TB cases. The present study aims to assess healthcare provider (HCP) knowledge, attitude and perceived stigma regarding TB and perception about traditional healers. A descriptive cross sectional study was conducted among 108 HCPs using a semi-structured, self-administered questionnaire from September 2014 to January 2015. The study district has a high TB burden area with one district hospital, 4 health centres, and 18 health posts. All health facilities and HCPs available during the study period in the district were included in the study. Statistical software for social science (SPSS) version 22 and STATA version 14 were used to enter and analyse data, respectively. The majority (64%) of the HCPs had poor overall knowledge regarding TB, and 67.6 and 57.6% had poor knowledge regarding TB diagnosis and nature of the disease, respectively. Moreover, most 66.7 and 55.6% of the HCPs had an unfavourable attitude towards TB and TB control systems, respectively. Slightly under half (49.1%) of the HCPs had a favourable attitude towards TB patients, and the majority (88.9%) had low perceived stigma. The majority (87.0%) of the HCPs indicated the importance of community involvement in TB control activity. Moreover, most (60.2%) of the HCPs showed willingness to collaborate with traditional healers (THs) on TB control activity. Healthcare workers’ knowledge gap and unfavourable attitude towards TB control systems reported in this study may cause poor TB care delivery. HCPs’ perception of the importance of community involvement in TB control and willingness to collaborate with THs on TB management could be an opportunity to strengthen the World Health Organization’s (WHO’s) component of End TB strategy through community engagement. Training and workshops could be used to address the knowledge gap and the unfavourable attitude regarding TB among HCPs.

/pdf/health-care-providers-knowledge-attitude-and-perceived-4debcqz720.pdf

Health care providers’ knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia: a cross-sectional study

Background 
Ethiopia is ninth among the world high tuberculosis (TB) burden countries, pastoralists being the most affected population. However, there is no published report whether the behavior related to TB are different between pastoralist and the sedentary communities. Therefore, the main aim of this study is to assess the pastoralist community knowledge, attitude and perceived stigma towards tuberculosis and their health care seeking behavior in comparison to the neighboring sedentary communities and this may help to plan TB control interventions specifically for the pastoralist communities.


Method 
A community-based cross-sectional survey was carried out from September 2014 to January 2015, among 337 individuals from pastoralist and 247 from the sedentary community of Kereyu district. Data were collected using structured questionnaires. Three focus group discussions were used to collect qualitative data, one with men and the other with women in the pastoralist and one with men in the sedentary groups. Data were analyzed using Statistical Software for Social Science, SPSS V 22 and STATA.


Results 
A Lower proportion of pastoralists mentioned bacilli (bacteria) as the cause of PTB compared to the sedentary group (63.9% vs. 81.0%, p<0.01), respectively. However, witchcraft was reported as the causes of TB by a higher proportion of pastoralists than the sedentary group (53.6% vs.23.5%, p<0.01), respectively. Similarly, a lower proportion of pastoralists indicated PTB is preventable compared to the sedentary group (95.8% vs. 99.6%, p<0.01), respectively. Moreover, majority of the pastoralists mentioned that most people would reject a TB patient in their community compared to the sedentary group (39.9% vs. 8.9%, p<0.001), respectively, and the pastoralists expressed that they would be ashamed/embarrassed if they had TB 68% vs.36.4%, p<0.001), respectively.


Conclusion 
The finding indicates that there is a lower awareness about TB, a negative attitude towards TB patients and a higher perceived stigma among pastoralists compared to their neighbor sedentary population. Strategic health communications pertinent to the pastoralists way of life should be planned and implemented to improve the awareness gap about tuberculosis.

/pdf/knowledge-attitude-and-perceived-stigma-towards-tuberculosis-pmli92s4wr.pdf

Knowledge, attitude and perceived stigma towards tuberculosis among pastoralists; Do they differ from sedentary communities? A comparative cross-sectional study.

ABSTRACT Purpose Road Traffic Injury (RTI) is major public health concern globally and is excessively affecting vulnerable road users in the pacific Island nations. This study aimed to explore and understand the perception of Public Transport Drivers (PTDs) on risk factors and the existing prevention strategy of RTI in Vanuatu. Methods This study employed qualitative methods that used 31 In-Depth Interviews (IDIs) to gather data from PTDs from 14 October to 30 November 2020. Purposive sampling was used to recruit PTDs from three main municipalities, Luganville, Port Vila and Lenakel. Semi-structured open-ended questionnaire were used to gather data. Interview data was transcribed and manual thematic analysis was performed to analysis the data. Results Data saturation was reach from interviewing 31 PTDs who were all male. Five main themes were generated from the study including the trend of RTI, the determinants of RTI, high-risk road users, traffic law enforcement and public education. The respondents perceived that the best measures for preventing RTI include community education, enforcement of road traffic control laws and addressing specific road infrastructure issues. Conclusions Changing driver behaviours, community education on road safety and enforcement of traffic laws are essential for preventing RTI in Vanuatu.

https://www.tandfonline.com/doi/pdf/10.1080/17482631.2022.2047253?needAccess=true

The perception of public transport drivers (PTDs) on preventing road traffic injury (RTIs) in Vanuatu: a qualitative study

Setting: National tuberculosis control programme, Vanuatu.

Objective: To assess tuberculosis (TB) trends, characterise sputum smear-positive patients with non-conversion at 2 months and assess their treatment outcomes.

Design: Evaluation of programme data over a 9-year period (2004–2012), comparing 2-month sputum non-converters (delayed converters) with sputum smear converters diagnosed in 2011 and 2012.

Results: Annual TB case numbers were similar over the study period, with an average TB notification rate of 58 per 100 000 population. Of 417 sputum smear-positive cases, 74 (18%) were delayed converters. Delayed converters were more likely than converters (88% vs. 79%) to have had high pre-treatment sputum smear grades (OR 2.5, 95%CI 0.97–6.45). Among delayed converters, treatment adherence was high (99% good adherence), outcomes were generally good (90% treatment success, 85% cure, 4% treatment failure) and no drug resistance was detected. Deaths were unexpectedly common among converters (11/80, 14%), with significantly more deaths in Tafea than in Shefa Province (7/58 vs. 2/80, OR 5.35, 95%CI 1.07–26.79). Tafea Province also had the greatest number of delayed converters (30/74, 40.5%) and the highest TB incidence rate.

Conclusion: Delayed sputum conversion was relatively uncommon, and was not associated with adverse outcomes or drug resistance. Regional differences require further investigation to better understand local factors that may compromise patient management.

/pdf/profile-of-tuberculosis-patients-with-delayed-sputum-smear-3xudn65ty3.pdf

Profile of tuberculosis patients with delayed sputum smear conversion in the Pacific island of Vanuatu.

Around 1.35 million deaths are caused by Road Traffic Injuries (RTIs) each year. This study aimed to explore the perceptions of Vanuatu's Health Care Workers (HCWs) regarding the existing preventative strategies for RTI.In 2020, this study used qualitative approaches to collect data from HCWs using Focus Group Discussions (FGDs). Study participants were self-identified Ni-Vanuatu HCWs who had been serving for more than 6 months in three main hospitals where the study was conducted and purposive sampling was used to gather the study participants. To guide the FGDs, a semi-structured open-ended questionnaire was created. Thematic analysis was used to processed the data obtained, based on predetermined themes that were based on theory while also enabling the data to determine new themes.From 5 FGDs with 22 HCWs who were emergency nurses, doctors and public health officers, data saturation was reached. The study yielded five main themes and sixteen subthemes. The relevance and trends of RTI, barriers to effective care, pre-hospital management capacity, barriers to pre-hospital care and addressing RTI were among the key subjects. The findings suggest that addressing health institutional leadership and resources will improve prevention of RTIs.Prevention of RTIs is hindered by the lack of health institutional capacities in terms of leadership and resources that include emergency equipment, financial and trained human resources. The health sector should consider developing stronger leadership in road safety to be an essential part of its core business. 

“Road traffic injury could be minimized when individual road users take more responsibility for their safety and the safety of others”: Perception of healthcare workers in Vanuatu

Background
This study was conducted in the Pacific island nation of Vanuatu. Our objective was to assess knowledge, attitudes and practice of traditional healers who treat lung diseases and tuberculosis (TB), including their willingness to collaborate with the national TB programme.

/pdf/traditional-healers-and-the-potential-for-collaboration-with-1ehoslt1v7.pdf

Traditional healers and the potential for collaboration with the national tuberculosis programme in Vanuatu: results from a mixed methods study

Behavior change interventions for dangerous driving behavior in low- and middle-income countries: a systematic review of interventions and outcome measurement instruments

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